Thanks much for posting this, fascinating stuff.
Lots of interesting nuggets in this article, but a couple of my takeaways:
"Observational studies show a continuous positive relationship between CHD risk and LDL levels that extends well below the average range seen in modern populations without any definite threshold where lower LDL concentrations are not associated with lower risk (27)."
"Interestingly, the LDL level at which the cardiovascular event rate is predicted to approach 0 is 57 mg/dl for primary prevention and 30 mg/dl for secondary prevention."
If I understood correctly, the posited "optimal" target LDL range of 50-70 would lead to a halt in atherosclerosis. But what about reversal, which for me is a goal much superior to halting CHD progression? Might LDL lower than 50-70 be necessary, along with a truly healthful diet, at least for some, to achieve reversal?
I'm not sure how to reconcile these two pieces:
"Cholesterol is an essential component of the cell membrane and an obligate precursor for bile acid, steroid hormone, and vitamin D synthesis. Consequently, it is likely that a physiologically ideal range of blood cholesterol exists above and below which adverse health consequences might be expected."
and a bit later:
"People with heterozygous hypobetalipoproteinemia have total cholesterol levels as low as 80 mg/dl and LDL cholesterol levels as low as 30 mg/dl (30). This condition is associated with longevity (31), presumably due to the absence of atherosclerosis, but the lack of other adverse effects that might have accompanied a low LDL level suggests that such low levels of LDL are safe."
Are the authors suggesting that, if there is cholesterol threshold below which harm is likely, than that threshold is below 80 TC and 30 LDL?
Lots of food for thought in this article, thanks again for posting. I need to read it about 5 more times.
A tangential point I'd make is that all the LDL reductions cited in the study seem to have been accomplished through statins. Imagine how much better to accomplish similar cholesterol effects through a WFPB diet and then, as a huge bonus, get all the other many benefits as well!